Healthy kidneys help the body by removing waste and extra water, and keeping the blood clean and chemically balanced . When the kidneys stop working properly - as is the case when someone has kidney disease - 'waste' can build up in the blood and damage the body. Chronic kidney disease (CKD) is when the kidneys gradually stop working . End-stage renal disease (ESRD) is when the kidneys have totally or almost totally stopped working. People with ESRD must either have regular dialysis (be hooked up to a machine that filters the blood) or have a kidney transplant to stay alive.
ESRD affects Indigenous people when they are much younger compared with non-Indigenous people. In 2009-2015, almost three-in-five Indigenous people who were diagnosed with kidney disease were younger than 55 years (less than one-third of non-Indigenous people were younger than 55 years) (Figure 1) (Derived from ).
Figure 1. Rates (per million) of end-stage renal disease for Indigenous and non-Indigenous people, by age-group (years) 2009-2013
Note: These rates show how many Indigenous and non-Indigenous people had ESKD per million. This means, for example, that for every 1 million Indigenous people aged 55-64 years, over 1,800 had ESKD in 2009-2013.Source: Derived from ANZDATA, 2014 , ABS, 2014 , ABS, 2011 , ABS, 2003 
Dialysis was the most common reason for Indigenous people to be admitted to hospital in 2012-13 . Almost one-half of all Indigenous hospital admissions were for dialysis. Indigenous people were admitted to hospital for dialysis around 10 times more often than other Australians .
Some people need to have dialysis every day. Dialysis can be undertaken at hospitals, special out-of-hospital satellite units, or in the home (which requires special equipment and training for the patient and their carers, and is very costly) . Accessing dialysis can sometimes be very difficult for Indigenous people who live in rural or remote locations and they may have to travel to receive treatment.
In 2008-2012, Indigenous people were almost three times more likely to die from kidney disease than non-Indigenous people .